Club foot (CF) is characterized by multiple deformities such as varus, adductus and internal rotation of the forefoot. It is well-known and a frequent congenital disorder. CF can concurrently be seen with several diseases but it can rarely manifest as a component of any other syndrome. Ritscher-Schinzel syndrome, or cranio-cerebello-cardiac ...

There is evidence that Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is accompanied by gastro-intestinal symptoms; and IgA and IgM responses directed against lipopolysaccharides (LPS) of commensal bacteria, indicating bacterial translocation. This study was carried out to examine gastro-intestinal symptoms in subjects with ME/CFS versus those with chronic fatigue (CF). The two ...

Middle East respiratory syndrome coronavirus (MERS-CoV) is currently the focus of global attention. In this review, we describe virological, clinical, epidemiological features and interim travel advice and guidelines regarding MERS-CoV. We compare and contrast these with the severe acute respiratory syndrome coronavirus (SARS-CoV). MERS-CoV is a novel β CoV that ...

A 33-year-old man was denied work permit due to chest X- ray findings of bilateral upper lobe fibrosis, assumed to be due to tuberculosis. However, a detailed evaluation showed that the upper lobe fibrosis was due to Marfan's syndrome.

The pathogenesis of postural orthostatic tachycardia syndrome (POTS) is poorly understood. However, it has been suggested that altered immune activity or denervation of the autonomic system following illness may be an important trigger. Patients infected with Lyme disease have a small incidence of post-Lyme disease syndrome that share similar characteristics ...

To effectively track the growth of influenza, we piloted an online system to monitor influenza-like illness (ILI) in the community in one district of Hong Kong. Four syndromic markers, namely fever, respiratory symptoms, fever with respiratory symptoms, fever and/or respiratory symptoms, either of the individual or of the household, were ...

The Middle East respiratory syndrome (MERS) is a new killer respiratory disease caused by the MERS coronavirus (CoV) first reported from the Kingdom of Saudi Arabia (KSA) in September 2012, after identification of a novel betacoronavirus from a Saudi Arabian patient who died from a severe respiratory illness (1, 2). ...

Hui David S DS aDepartment of Medicine & Therapeutics, Stanley Ho Center for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong bMinistry of Health, King Faisal University, Riyadh, Kingdom of Saudi Arabia cDivision of Infection and Immunity, Department of Infection, Centre for Clinical Microbiology, University College London dNIHR Biomedical Research Centre, University College London Hospitals, London, - - 2014

This review compares the clinical features, laboratory aspects and treatment options of severe acute respiratory syndrome (SARS) and the Middle East respiratory syndrome (MERS). Bats are the natural reservoirs of SARS-like coronaviruses (CoVs) and are likely the reservoir of MERS coronavirus (MERS-CoV). Although a small number of camels have been ...

A 59-year-old man with a history of type 2 diabetes and a left nephrectomy following trauma reported of malaise and weakness. He reported a penile ulcer 2 months earlier, but there had been no lymphadenopathy or fever. His speech was slurred, he was breathless on minimal exertion and there was ankle ...

Hermansky-Pudlak syndrome (HPS) is a rare autosomal recessive disorder characterized by oculocutaneous hypopigmentation, platelet dysfunction, and in many cases, life-threatening pulmonary fibrosis. We report the clinical course, imaging, and postmortem findings of a 38-year-old female with HPS-related progressive pulmonary fibrosis, highlighting the role of imaging in assessment of disease severity ...

Mirizzi's syndrome is a rare complication of gallstone disease, that gallbladder lumen can lie alongside the common hepatic duct, resulting in inflammation and resultant bile duct stricture. Most cases are not identified preoperatively. Variations of the cystic duct and its point of union with the common hepatic duct are surgically ...

The manifestations of human monocytic ehrlichiosis range from a mild febrile syndrome to a severe multisystem illness. Myocardial involvement is uncommon. We report a woman, 78 years of age, who was treated with trimethoprim/sulfamethoxazole after a tick bite, in whom myocarditis was subsequently diagnosed. She recovered completely after doxycycline therapy.

Objectives. We compared school nurse visit syndromic surveillance system data to emergency department (ED) visit data for monitoring illness in New York City schoolchildren. Methods. School nurse visit data recorded in an electronic health record system are used to conduct daily surveillance of influenza-like illness, fever-flu, allergy, asthma, diarrhea, and ...

Violent behavior has frequently been reported in cases of Capgras' delusion, a misidentification syndrome characterized by the false belief that imposters have replaced people familiar to the individual. To better understand the relationship between Capgras' syndrome and violence. After a brief overview of the scientific knowledge of delusional misidentification syndromes, ...

Young men presenting with sexual problems arising out of non-contact like semen loss syndrome are common in the Indian subcontinent. They usually present with depressive, anxiety symptoms, and non-specific somatic complaints. This has no medical explanation and is currently conceptualized as a culture bound neurotic disorder in the International Classification ...

To explore the laws governing the distribution of Traditional Chinese Medicine (TCM) syndrome elements (SEs) of senile diabetes (SD) and their relationship to relevant factors. An investigation of patients who met the inclusion criteria was conducted by trained doctors, using case report forms. All related data were collected, including body ...

Introduction: Differing patterns of neurophysiological abnormalities have been reported in patients with Fisher syndrome. Fisher syndrome is rare and few series have incorporated prospective serial studies, which have proven helpful in defining the natural history of nerve conduction studies in Guillain-Barré syndrome. Methods: In an ongoing prospective study of Guillain-Barré ...

Khan I D ID Department of Pathology and Molecular Medicine, Army Hospital Research and Referral, New Delhi 110010, - - 2013

In a first of its kind, a 20 year old Hindu, highlander, working girl presented with abnormal behavior, unrelenting symptoms, had limited benefit by usual treatment and was diagnosed as Possession syndrome. Exorcism offered symptomatic relief. The girl resumed normal activities with no recurrence in a 12 month follow up. ...

This paper reports a case of a Jamaican young woman who experienced flaccid quadriparesis and bulbar weakness over a three-week period after a gastrointestinal illness. Nerve conduction studies confirmed an axonal type neuropathy consistent with the acute motor-sensory axonal neuropathy variant of the Guillain-Barré syndrome. Recovery, although evident, was slow ...

Patients presenting with nephrotic syndrome with or without nephritic illness rarely come across with the diagnosis of 'C1q nephropathy'. This entity is purely diagnosed with the help of immunofluorescence like IgA nephropathy. Clinical presentation is heterogenous, ranging from nephrotic range proteinuria to sub-nephrotic state; and with or without hematuria / ...

Middle East Respiratory Syndrome coronavirus (MERS CoV) came to attention as an emerging pathogen causing severe respiratory illness in patients from the Middle East in September 2012. As of 14 June 2013, 58 human cases of MERS CoV infection have been confirmed, including 33 deaths (case fatality rate of 57%). ...

Cold agglutinin syndrome (CAS) secondary to infection is rare, usually presenting with anaemia and minor skin changes. A 12-year-old girl with secondary CAS associated with extensive cutaneous necrosis is reported. She presented with fever and multiple necrotic lesions over both cheeks, the tip of nose, ear margins, hands and buttocks, ...

Papillon-Lefèvre syndrome is characterised by palmoplantar keratoderma, periodontitis and pyogenic infections. We describe the first case of brain abscess in a child with this syndrome. We highlight the importance of recognising any associated diagnosis, however rare or apparently irrelevant, in an acutely and critically ill child.

Anticonvulsant hypersensitivity syndrome (ACHSS) is rare and defined by a group of systemic symptoms: a typical clinical triad with skin rash, high fever and lymphadenopathy, with or without multiple organ dysfunctions. Its variable presentation renders diagnosis particularly difficult yet important, as delayed diagnosis can lead to serious complications. We describe ...

Objective. To explore processes of conceptualizing nodding syndrome (NS), an unknown illness which has been reported to affect thousands of children in post-conflict northern Uganda, in South Sudan and in Tanzania. Design. This qualitative study comprised 40 in-depth interviews with affected families, health workers and politicians during five months of ...

Low plasma citrulline levels have been associated with a reduction of functional gut mass in various clinical situations. In critically ill patients, citrulline variations are tricky to interpret because of sepsis, vascular abnormalities, and multiple organ failure. In the previous issue of Critical Care, Ware and colleagues made an important ...

Hemolyitic uremic syndrome (HUS), characterized by triad of acute kidney injury, thrombocytopenia, and hemolytic anemia, has considerable morbidity and mortality and is known to be associated with diarrheal illness. It usually occurs after a diarrheal illness due to Shiga-toxin-producing Escherichia coli. Streptococcus pneumoniae is a rare but well recognized trigger ...

Posterior reversible encephalopathy syndrome (PRES) is a neurological disorder characterised by distinct radiological features. Common precipitants of this disorder include acute medical illness, hypertensive crisis, eclampsia, immunosuppressive therapy and chemotherapy. We present the case of a patient with advanced ovarian carcinoma who developed PRES shortly after receiving bevacizumab (Avastin), an ...

Guillain-Barré syndrome is an immune-mediated polyneuropathy that frequently presents with progressive muscle weakness. Hyponatremia has recently been described as a feature of this condition, generally appearing over the course of the illness and following the diagnosis of this demyelinating process. We report a case of Guillain-Barré syndrome presenting with severe ...

Restless legs syndrome (RLS) rarely affects the upper limb during the initial course of disease. We present a patient who complained of symptoms suggesting RLS in the right upper limb as the sole manifestation of illness. Bilateral cervical ribs and depression were co-incidental findings. Patient responded well to dopaminergic therapy.

Delusional misidentification syndromes are a group of delusional phenomena in which patients misidentify familiar persons, objects, or themselves, believing that they have been replaced or transformed. In 25%-40% of cases, misidentification syndromes have been reported in association with organic illness. We report an acute episode of Capgras-like delusion lasting 8 ...

Patients with severe mental illness are at increased risk of developing metabolic disorders. The risk of metabolic syndrome in the Hong Kong general population is lower than that observed in western countries; however the prevalence of metabolic syndrome in patients with severe mental illness in Hong Kong is unknown. This ...

AIM: To examine clinical characteristics, treatment and outcome of Kawasaki syndrome patients in Denmark. METHODS: A retrospective chart review of hospitalization records for children <15 years of age with a Kawasaki syndrome discharge diagnosis identified through the Danish National Patient Registry during 1994 through June 2008 was conducted. RESULTS: A ...

AIM: Central and extrapontine myelinolysis are collectively known as osmotic demyelination syndrome. This encephalopathic illness has been well documented in the adult literature, occurring most commonly in the context of chronic alcoholism, correction of hyponatraemia, and liver transplantation. Aetiology and outcome in the paediatric population are less well understood. METHODS: ...

The aim of this study is to investigate psychosocial factors related to the diagnosis and treatment of patients with restless legs syndrome. Fifteen patients were interviewed at the Neuro-Sono Outpatient Clinic, Universidade Federal de São Paulo. The results were submitted to a qualitative analysis. We identified four content categories: illness ...

Medical Progress: Guillain-Barré Syndrome Review Article, N Engl J Med 2012;366:2294-2304. In the Clinical Features section, in the fourth paragraph under Diagnosis, beginning "A lumbar puncture . . ." (page 2296), the final two sentences should have read, "However, albuminocytologic dissociation is present in no more than 50% of patients with the ...

The diagnosis of carpal tunnel syndrome (CTS) is often applied in the absence of objectively verifiable pathophysiology (i.e. electrophysiologically normal carpal tunnel syndrome). The primary purpose of this study was to determine whether depressive symptoms, heightened illness concern, and pain catastrophizing are associated with an absence of electrophysiological abnormalities. The ...

This article describes an esophageal leiomyomatosis in mother and daughter. A 33-year-old woman with cardiovascular symptoms was admitted to the hospital. Her mother at a young age had undergone an esophagectomy because of a leiomyosarcoma. The daughter received a diagnosis of diffuse leiomyomatosis of the esophagus and uterus. Because of ...

Neurocysticercosis is a common childhood neurological illness in India. A variety of presentations have been reported in the literature, including weber syndrome. Neurocysticercosis, manifesting as Millard Gubler syndrome, have not been reported in literature. Therefore, we report a child presented to us with Millard Gubler syndrome due to pontomedullary neurocysticercosis ...

This review article discusses hereditary cancer predisposition syndromes with uterine manifestations. Lynch syndrome accounts for 2% to 3% of endometrial cancers. The identification of endometrial cancer patients at risk for Lynch syndrome is discussed, as are the characteristics of Lynch syndrome-associated endometrial cancer and the screening and prevention options for ...

Clinical manifestations of vesicouterine fistulas, a rare complication of cesarean section, include amenorrhea and cyclic hematuria (menouria) without urinary incontinence, a triad collectively known as "Youssef's syndrome." Fistulas affecting the uterus usually reside above the isthmus or at the cervix and have a distinct morphology composed of granulation tissue, chronic ...

Ovarian remnant syndrome (ORS) is the presence of functional ovarian tissue with signs of oestrus as a complication after ovariohysterectomy (OHE) or ovariectomy. Stump pyometra is another complication that can be observed after OHE. However, there are few reports about ORS and stump pyometra in queens. In this report, three ...

J Wave Syndromes. Introduction: Recently, great attention has been paid to the risk stratification of asymptomatic patients with an electrocardiographic early repolarization (ER) pattern. We investigated several repolarization parameters including the Tpeak-Tend interval and Tpeak-Tend/QT ratio in healthy individuals and patients with J wave syndrome who were aborted from sudden ...

We report two cases of intermittent Wolff-Parkinson-White (WPW) syndrome. In one patient, early repolarization (ER) was masked during preexcitation whereas in the other, J wave-like notches were observed in the right precordial leads only during preexcitation. The clinical significance of ER is not apparent in WPW syndrome but some possible ...

This study aimed at studying the histopathological effects of hyperandrogenemia and estrogen deficiency on larynx mucosa in experimentally designed polycystic ovary syndrome of female rats. Two groups of experimental polycystic ovary syndrome model were composed in healthy female rats by per oral letrozole administration of for 21 and 42 days. ...